A fairly engaging book. It combines a memoir of the author's 45-year relationship with the subject, with an account of the research done on the subjecA fairly engaging book. It combines a memoir of the author's 45-year relationship with the subject, with an account of the research done on the subject and knowledge gained about brain function. The author was also the most central neuroscientist of the many who studied HM. HM was the most studied neurology patient ever because of his amnesia, caused by an operation that removed both sides of his hippocampus to control epilepsy. This was done in 1953, before the consequences of this surgery were known.I took a special interest in this book and this case b/c I have a close friend who suffers from very similar amnesia. Their deficits and capacities are remarkably parallel. The difference is that my friend's brain damage was not cleanly caused in this way, but through limbic encephalitis which did not cause damage in any systematic way. This makes his brain less useful for research b/c it is harder to correlate behavioral deficits with specific physiological damage. The author gave a very humane account which turned a tragedy into a meaningful life....more

This gave me a lot of information in an interesting way. In addition to systematic accounts of conditions and options there is an extensive section ofThis gave me a lot of information in an interesting way. In addition to systematic accounts of conditions and options there is an extensive section of personal accounts. There is a clear preference expressed for ablations, which seems well-supported. Glad I read this....more

I read this b/c my friend Bob was to have brain surgery. His kind was not covered in the book as it turned out. But the book was interesting. I alwaysI read this b/c my friend Bob was to have brain surgery. His kind was not covered in the book as it turned out. But the book was interesting. I always compare medical/scientific memoir-type books with those of Oliver Sacks. Probably I need to stop doing that. The author of this book is not a wide-ranging intellectual the way Sacks was. But he has his own charm as a writer. He is a bit of a curmudgeon. But as the book went on, his personality gradually emerged, and you are glad to get to know him. He is British, and so we get a (somewhat negative) view of the British Health Service. Apart from the details of the brain problems, the book is also about the challenges of life/death/worse-than-death decision-making. How to judge almost unknowable risks and weigh them against possible benefits. Not a job I would be cut out for. But I'm glad for people like the author....more

A fine book that lives up to the praise it has received. I recommend it to anyone who will die, or even suspects that they might die. It was honest, iA fine book that lives up to the praise it has received. I recommend it to anyone who will die, or even suspects that they might die. It was honest, insightful and emotional without being maudlin. The author had an impressive combination of both scientific/technical interests and abilities, and pastoral/philosophical/humanistic ones. In addition to the personal tragedy that his early death was to his family and friends and patients, it is also a public tragedy that we have lost someone who would likely have been the next Oliver Sacks. I wanted to hear more from him, and I hope there are others with this same combinations of interests and abilities, but we'll have to see. I was saddened by the author's experience with philosophy. He went to Stanford as an undergraduate, and was apparently underwhelmed by his experience with ethics in an analytic philosophy class (p. 31). This drove him away and toward an affection for Richard Rorty, whom he claimed (p. 39) was "perhaps the greatest living philosopher of his day." That is far from the truth, though he is an interesting character. Rorty had a strong background and record in philosophy, from which he became alienated. After winning a MacArthur genius grant in 1981, Rorty more or less rejected philosophy for something closer to literary criticism. He in fact was housed in the literature department at Stanford, because the philosophers wouldn't have him. Anyway this led the author toward another, non-analytic, approach to philosophy that, unfortunately, had him quoting Heidegger (p. 104). I will give him credit though that in his last days (his wife reported, p. 218) he would hold his baby girl and read aloud to her various works, including Wittgenstein! (I had not thought of reading Wittgenstein to Kent, though there is a good children's book about the duck-rabbit, called "Duck! Rabbit!".)Beg, borrow, or steal a copy of this book, if you can't buy it, and read it....more

This is a paradigm of a good Oliver Sacks book--several essays allowing him to move from topic to topic, occasionally returning to earlier topics, notThis is a paradigm of a good Oliver Sacks book--several essays allowing him to move from topic to topic, occasionally returning to earlier topics, not calling for any grand theory, but noting similarities and differences. He treated autism in several places. But the most interesting essay to me was the 4th one: "To See and Not to See." Here he studies a man who is essentially given sight in adulthood after a cataract operation. The man did not have a great desire for this operation, but his fiancee did--who was excited by the expanded life this man would have. However, the story is a tragedy more than anything else. He never gets very good at seeing, mostly regresses/retreats into blindness, and soon dies. What is impressive about the story is how you come to sympathize with the man. While Sacks never mentions the parallel, it sounds much like Plato's Parable of the Cave, and gives me new insight into the attitude of the chained prisoners who don't want to be freed or taken from the cave. The man had developed a complete world--not a world in which something was missing. So when a new dimension was opened up, there was no obvious place for it to go. Rather as though someone offered to give you an additional sense--wouldn't you want it? But the problem is how to incorporate it into the complete world that you already inhabit. This gave me an understanding of people who insist that blindness or deafness are not "disabilities." While there are certain (of our) abilities that such people lack, they are compensated for by the enhancement of other abilities (probably to a degree that we lack). And I can see why such people do not want to be considered disabled or handicapped. The story also made clear how sight is an achievement, not simply a window on the world, that is developed over many months, if not years, and developed at a time in brain development when space for it is provided. When that space is not used at the appropriate time, it doubtless gets devoted to other things (and so the enhanced senses that we others lack). Oliver Sacks died 3 months ago today, and he is and will be sorely missed. I hope to learn of other humanistic scientists, or scientists who are storytellers. But he was a great one. Thanks. RIP....more

A memoir by her husband of Iris and their life together. Her life ended with Alzheimer's, and so did theirs together--the book is written from that peA memoir by her husband of Iris and their life together. Her life ended with Alzheimer's, and so did theirs together--the book is written from that perspective. I was interested to read the book for that reason, and from an interest in Murdoch as a novelist and philosopher. Bayley's descriptions of her Alzheimer's time sounded genuine and were touching. The book is not very revealing or engaging. Murdoch seems to have been a very inward person, and her husband does not have much insight into her inner life. In fact he makes a sort of point of not having or offering that. One of my teachers in grad school, Philippa Foot, was a close friend of Murdoch's. Foot was mentioned by name once in the book, but in a way that was of no importance. ...more

Even though this is not one of Sacks' better-known books, this is why I love Oliver Sacks--scientific, yet personal and philosophical. He recounts hisEven though this is not one of Sacks' better-known books, this is why I love Oliver Sacks--scientific, yet personal and philosophical. He recounts his own leg injury with nerve implications from the personal point of view. This leads him through reflections on the phenomenological aspects of embodiment, and on the experience of being a patient. He emphasizes how both these perspectives are missing in his field of neurology, and he determines to set out on a science of neuropsychology that will include them. His experiences were from 1974, and he published this book in 1984. I first read this book 20 years ago, and just reread it. Some noteworthy things in the book: He recalled his own experience of electrical simulation of the neck which (p. 131) had the effect not simply of shrugging, but of "a sudden impulse to shrug," so that the experience of free will is caused along with the action (and p. 129). He tries to talk about the very moment/point of engagement between mind and body. This comes especially when he begins to (re)use his injured leg. He recounts the experience of reintegrating his leg into his bodily space and will in very (and self-consciously) Kantian terms (pp. 138-40). He emphasizes the importance of doing--even quoting the Faustian line: "In the beginning was the deed." His discussion of physical therapy reminded me very much of my father's physical therapist, David Smartt. This role is very important--mostly as a cheerleader. Sacks emphasizes the need for positivity and activity. The most important thing is not to get the patient to "try," which even seems impossible to the patient, but to put the patient in a situation where s/he will spontaneously act.I reread the book b/c I am about to send it to someone who broke his pelvis and has nerve damage…I hope it will be a useful and interesting read for him....more

This book is a memoir by a doctor who moved with his family to inner-city Washington DC to care for and work with the poor. He was part of a medical mThis book is a memoir by a doctor who moved with his family to inner-city Washington DC to care for and work with the poor. He was part of a medical mission, Christ House, which is itself part of a far larger collection of missions that go under the banner of the Church of the Saviour. The Church of the Saviour was started about 65 years ago by Gordon and Mary Cosby. A week ago today I was in the very building and ministry that this book is about, visiting with Gordon and Mary, whom Kathy has known for 35 years. They are at the end of their lives, but the flame burns brightly in them, their vision, and the ministries it has spawned. Those familiar with Elizabeth O'Connor's "Eighth Day of Creation" know another manifestation of that Church.The fact that Christ House has continued now for over 30 years is a testament to the faith and work of folks like the author, Hilfiker. The book was written almost 20 years ago, about experiences reaching back 30 years. It is a sobering book for anyone unfamiliar with urban poverty. And it is sobering to think that things can only have gotten far worse in the intervening 20 years. But it is an extremely honest and revealing book about the personal challenges of trying to do something positive in those circumstances. Of the many stories of individuals in this book, it was revealing that only the last full chapter was a story with a genuinely positive ending. And the epilogue suggested some other positive outcomes. But perhaps the moral of the stories was that outcomes and consequences are not the appropriate currency of ministry. What Hilfiker learned was the importance of being with and accompanying people on their journeys, and the realization that we are all children of God who try the best we can...and still fail. But that is ok, and that is the message of Jesus. About 35 years ago I was dipping my toes into similar challenges in Chicago, and took another direction. But the challenges are ones that I still can hear and feel. Mary Cosby was a delight to talk with, finding relief in her condition which required others to look after her and being unable to look after numerous ministries. Her ministry was now one of friendship and encouragement. Gordon, on the other hand, almost literally on his deathbed, continues to minister in any way he can. He told us he is focussing on deepening his prayer life (which is really saying something). He talks with God, and spent some time wondering about how he can distinguish between God's voice and his own inner voice. A voice in prayer recently told him that the needs in Anacostia are so great that he needs to begin a ministry there and raise $300,000 to do it. He could hardly believe he was being told to do this, being unable to visit people anymore--but he has persevered. He asked God whom he should ask, and God told him to ask three people-the first being himself. Suffice it to say that Gordon raised $250,000 in short order. Because what he still has is a prophetic authority that he can bring to the better-off among us, and so he continues to do that. I am told that Gordon once preached a sermon on a Sunday morning and when, the following Sunday morning, he preached the very same sermon, he was asked why--had he not had time to prepare another? No, he said, he could have prepared another, but as far as he could tell no one had done anything he called for the last Sunday, so he decided they needed to hear the call again! Gordon is the closest living thing we have to an Old Testament prophet. Dr. Hilfiker went on to found a new medical mission, Joseph's House, for those dying of AIDS, bringing him even closer to the poor he struggled to understand and love. This mission was oriented more toward the journey and less toward the outcome. This mission continues, and we have visited there as well, meeting with a friend who volunteers and lives there. Dr. Hilfiker has recently been diagnosed with Alzheimer's, but continues to share his journey: http://www.davidhilfiker.com . Words like "God" and "Jesus" hardly appear in this book, but if you want to know what it is to live in Christ, read this book, and other books that have come out of the Church of the Saviour community, including Gordon's collection of sermons: "By Grace Transformed."...more

An interesting read, rather like it is interesting to go to the zoo. Sachs collects odd neurological cases, sorts them into books, and publishes them.An interesting read, rather like it is interesting to go to the zoo. Sachs collects odd neurological cases, sorts them into books, and publishes them. He has a wide range of cases from his own practice, but by now people all over the world write to him with their bizarre conditions, so he has a lot to draw on. My recollection is that he used to go deeper in reflection about cases, but now he is mostly content to describe them and move on. Still, I like going to the neurological zoo now and then....more

A first-person account of auto-immune encephalitis. Apparently it manifests in many different ways, as this has only some resemblances to the case ofA first-person account of auto-immune encephalitis. Apparently it manifests in many different ways, as this has only some resemblances to the case of my friend, Bob. There is also some general information in addition to the anecdotal--that it takes about 7 months from initial attack until the victim is pretty functional, and that it can take 2-3 years for the victim to feel back to normal. But it is unclear whether this "normal" is what it was like before, or what the victim now considers (the new) normal. A scary disease we do not usually understand....more

Some pretty rough descriptions, which illustrate the author's general point that death is rarely the serene, dignified experience for which we hope. ISome pretty rough descriptions, which illustrate the author's general point that death is rarely the serene, dignified experience for which we hope. It was not the prospect of my own death that motivated me to read this, but I couldn't help thinking about that as well. Though much of the book is taken up with describing at various levels the processes of death, the author also wanted to emphasize the difficulty and the importance of patients and their families taking some control of the process away from the medical-technological process that will otherwise dominate. The author regrets the power of specialists whose primary or sole motivation is curing or prolonging life regardless of the human cost. He quotes (p. 275) the director of the UCLA Medical Center who said in 2009: "If you come into this hospital, we're not going to let you die." It sounds like a perverse kind of hell. Instead, the author wishes that there were ways to value and promote family practitioners who would care about pastoring the patient as much as winning the battle. I have such a family doctor, but since he is several years older than I am, I wonder if he'll still be practicing when I need him.The main issue is deciding when it is time to stop trying and accept death. The problem is that doctors still too often don't know, and aren't happy letting patients decide, when enough is enough. This is not a lesson I needed to learn about, but it is important to think about it in advance, for oneself and one's loved ones. The discussion also reminded me of analogous issues such as when it is time to stop trying to save a dying relationship, or when it is time to stop trying to pursue an ill-fated project or profession. Hope is an important virtue, but it also has its limits. As Aristotle could have said, there can be too little hope, but there can also be too much. The author thinks we need to reconceive what we mean by hope near the end of life. Death will always win in the end. But he thinks that we can still hope for and work toward being ourselves to our last breath. Even this can be taken away from us by the ravages of death, but it is something we can aim for--to be oneself as long as possible. I really should give 5 stars to a doctor who quotes Vaclav Havel (p. 281) on hope, in a book about medicine; but the unnecessary repetitions led me to reduce the rating by a star. In any case, well-worth reading--especially since each of us will eventually die, or at least we know someone who will. :)...more

Very practically oriented, with lots of suggestions. Two points that are very firm: 1) Use it or lose it. The longer you can keep someone doing particVery practically oriented, with lots of suggestions. Two points that are very firm: 1) Use it or lose it. The longer you can keep someone doing particular things, the more functional they will remain in general. 2) Don't try to fix the person--accommodate yourself to where the person is. There is a huge temptation to try to correct the person's misunderstandings or behavior. But this is pointless. Diverting the person's attention, and modeling what you want the person to do is always better. The book makes clear how much responsibility is on the caretaker to be upbeat and creative in addressing tasks. The book is very realistic in what can(not) be expected. Sobering but worthwhile....more

Subtitled: "A Biography of Cancer." A long and sometimes difficult book--but well-written, well-done, and well worth reading. How a doctor near the beSubtitled: "A Biography of Cancer." A long and sometimes difficult book--but well-written, well-done, and well worth reading. How a doctor near the beginning of his career would have time to research and write this is beyond me. I'm glad he did.When I started reading this I noted on Goodreads: "No, I don't." ...that is, don't have cancer. But I feel better prepared if I am diagnosed, or if someone I know is diagnosed. In fact I have not been much touched by cancer, but it did start me to thinking about how cancer has impinged on my life. My maternal grandmother had a radical double mastectomy in the 1950's. I didn't know this and wouldn't have guessed until my mother told me--maybe sometime in the 1990's. And my mother suspected that she hadn't in fact had breast cancer, but it was done as an overly aggressive preventive measure. That is very much in tune with the story told here. There was a trend at that time toward thinking that radical surgery was the fix. This was connected with a typical conflict between the doctor's desire to win at all costs, and the adverse effects on the patients. But it is true in this case that my grandmother did not die of cancer (if she ever had it). She lived to 94. My first conscious encounter with cancer was when my paternal grandmother's sister, who was a smoker, whispered to my parents about health problems that she had, but she would not use the word "cancer" and she would not in any case see a doctor. She did presumably die of lung cancer (in her 70's), but without having to suffer any of the indignities of treatment. "Cancer" is often feared as a dangerous word, as though saying it can cause it. And once when someone found out I was reading this book, the person reacted as though I was acting foolishly or playing a dangerous game of tempting cancer by reading about it. That magical aspect of cancer was never discussed in the book, but I recall it as a common feeling--especially in past decades. I suppose it is connected with the fact that we really don't understand the causes and cures for cancer, and what we don't understand we tend to treat supernaturally. Another part of my history with cancer is that both my parents were smokers. My father switched from cigarettes to cigars and then a pipe before I was born. My mother smoked cigarettes until the mid-70's. I was quite aware when the Surgeon General's report about smoking came out in the mid-60's. That slowly but eventually led to both my parents stopping smoking. I am very impressed that they were able to stop, b/c I know that is not easy. I have never smoked, but I have 2 relatives who struggle with smoking--being unable to quit permanently. My own closest connection with cancer is colonoscopies, which I have had every 5 years since I was about 40. These have been done b/c of my supposed family history. I am surprised how completely painless they are, and I would say they are a use of technology at its best. So, while no one close to me has died of cancer, it is striking how the structures that have grown up around cancer have involved me, as they have involved almost everyone.I was very interested in the understanding of cancer that has emerged. We tend to think of cancer as a thing, but it really is not. Talk of a war on cancer is misleading, just like talk of a war on terror is misleading. Cancer is not an invader, so much as it is an exaggeration of processes that are normal in cells--reproduction and growth. Cancer occurs when genes in cells that control division through acceleration and braking and cell death become dysfunctional through mutation. Sometimes the mutation is caused by external agents, sometimes by inheritance, and sometimes by accident. That is why it is so hard to conceptualize a "cause" of cancer. It is really caused by things that occur naturally in cells, only when they get out of control. And the ways that can happen are quite varied. So the means for preventing or treating cancer are also quite varied. Since cancer is in a sense an exaggeration of life, it will not be cured per se. It can be countered in various ways. Again, like the war on terror, it will not be won--rather, we can hope for a satisfactory state of protection. It was interesting that this was called a "biography" of cancer. A biography generally starts with a birth and ends with a death. This story has neither--but it certainly is a kind of life story. I am very grateful to researchers who have made as much progress as they have on ways to prevent, screen and treat cancer. It sounds like it is often a grueling process. In 2 weeks I am running in the local Relay for Life to raise money for cancer research. I have done this for a few years now. Having read this book, I know much more about what people are dealing with, and what can be hoped for....more

Recently I had what was diagnosed as an ophthalmic migraine, or a scintillating scotoma. This was the second event in about 2 months. There was no paiRecently I had what was diagnosed as an ophthalmic migraine, or a scintillating scotoma. This was the second event in about 2 months. There was no pain associated with it, and apparently it is not a dangerous condition, but it was certainly attention-getting. I had been interested in this book for several years, so I took the occasion to read it. While I am an Oliver Sacks fan, this is my least favorite of his books so far (I've read almost all of them). His strength is when he looks at some case study and follows it deep and wide. He is unequalled at that. Here he undertakes something else--to give an account of a wide-ranging phenomenon. Ideally this would amount to a theory of migraine--its cause, nature, and treatment. He fortunately is wary and honest enough to know that the phenomena of migraine are extremely wide-ranging, so the prospects of saying something both interesting and applicable to the full range of phenomena are small. But the desire to do so nevertheless opens one to the temptation of saying things that are vague or untestable. Sacks does not avoid these temptations. But for the most part he is true to the phenomena. The deepest problem comes from the title of the book itself. We have this word "migraine," and so we suppose there must be something in reality that corresponds to it, about which we could have a theory. But when we are told that while "classical" migraines include headache and auras, and "common" migraines include headache but not auras, and auras by themselves can be "migrainous" phenomena even without pain (which is what I had), I wonder what you can do with that. One could take Wittgenstein's approach that a concept (like "migraine") can have a family-resemblance unity, that depends only on a variety of connections, none of which is necessary or common. Or one could take Socrates' approach that there must be some underlying unity of necessary and sufficient conditions (which seems awfully unlikely in this case). Or one could hold that the term "migraine" has just gotten out of hand, and is in need of some cleaning-up. This is the view sometimes called "eliminativism"--in that the term should be eliminated, and replaced by other more specific terms. This was the fate of earlier terms like "consumption" (the medical term, not the economic term--which was jettisoned in favor of more specific conditions such as pleurisy, lung cancer, emphysema, and tuberculosis). It would seem more profitable to separate out the variety of phenomena that go under the label of migraine, rather than persevering in a search for what holds it all together. This search for what holds it all together leads Sacks to emphasize the psychological over the physical aspects, since it's pretty clear there isn't a physical unity. Sacks may be right that we should not ignore the psychological aspects, but that may be more a consequence of his search for a unity--somewhere, somehow....more

A first-person narrative of a depression that becomes near-suicidal. Should be read by anyone who cares about someone who deals with significant depreA first-person narrative of a depression that becomes near-suicidal. Should be read by anyone who cares about someone who deals with significant depression. What pulled him back from the brink happened to be hearing a bit of music that recalled for him things that he wanted to live for. He notes how important it is to a depressive to hear that they can pull through, that it will pass, that there are things worth enduring for. While this was written before anti-depressive drugs became as common as they are now, he emphasizes that they did not for him, and do not, solve the problem of real depression....more

My father has had Parkinson's for several years and perhaps some aspects of dementia. The book puts into words many things my father does not express.My father has had Parkinson's for several years and perhaps some aspects of dementia. The book puts into words many things my father does not express. I am glad I read it. My father read it at my suggestion (he hardly reads anything!) and said it presented some of his issues accurately and well. Fortunately he does not have Lewy Body disease. ...more